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General NPI Number Information
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NPI Number | 1265246557
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Entity Type | Organization
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Legal Business Name | ROCKY TOP DENTAL SERVICES LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 800 S GAY ST STE P325
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City | KNOXVILLE
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State | TN
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Zip | 37929-9749
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Country | US
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Telephone | 678-761-5947
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Fax |
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Provider Business Mailing Address
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Address Line | 800 S GAY ST STE P325
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City | KNOXVILLE
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State | TN
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Zip | 37929-9749
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR OF EFFICIENCY SERVICES
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Name | MR. MAXWELL JANI
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Credential |
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Telephone | 678-761-5947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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